Provider Demographics
NPI:1225379043
Name:LA SPEECH THERAPY PC
Entity Type:Organization
Organization Name:LA SPEECH THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEIGHANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:PAIGE
Authorized Official - Suffix:
Authorized Official - Credentials:MS-CCC-SLP
Authorized Official - Phone:641-814-1141
Mailing Address - Street 1:207 W 2ND ST
Mailing Address - Street 2:SUITE 4
Mailing Address - City:OTTUMWA
Mailing Address - State:IA
Mailing Address - Zip Code:52501-2541
Mailing Address - Country:US
Mailing Address - Phone:641-814-1141
Mailing Address - Fax:866-611-9554
Practice Address - Street 1:207 W 2ND ST
Practice Address - Street 2:SUITE 4
Practice Address - City:OTTUMWA
Practice Address - State:IA
Practice Address - Zip Code:52501-2541
Practice Address - Country:US
Practice Address - Phone:641-814-1141
Practice Address - Fax:866-611-9554
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LA SPEECH THERAPY PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA002314273Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes273Y00000XHospital UnitsRehabilitation Unit